Results of first 2 weeks using PAP therapy...more questions!

zorrro13 · Post by **zorrro13** » Fri May 23, 2008 2:27 am

Okay an EPR of 3 is a big jump unless your really having difficulty with resistance. At around 10 in Apap you mentioned you could hardly feel any resistance right?

If it were me I would go back to basics. Did your Doc prescribe 13 or 14 straight Cpap? if so do that first no EPR for a while at least

or

Go to Apap and set the minimum to 13 or 14. This could be beneficial as it will do the same as straight cpap but give you some more flexibility and here's why... Even though the resmed wont interrupt a full blown apnea it will still react to flow limitation trying to prevent the apnea happening and at a minimum Apap press of 14 it is likely to detect flow limitation and react a lot quicker. I really hope some one can correct me if I'm a wrong

Maddcow · Post by **Maddcow** » Fri May 23, 2008 3:31 am

zorrro13 wrote:At around 10 in Apap you mentioned you could hardly feel any resistance right?

Correct

Did your Doc prescribe 13 or 14 straight Cpap? if so do that first no EPR for a while at least

Prescription of 13 CPAP but the machine came programmed for EPR at 3, so I assumed that was what they wanted for me.

Go to Apap and set the minimum to 13 or 14. This could be beneficial as it will do the same as straight cpap but give you some more flexibility <snip>

I'll do this tonight and let you know how it goes.

Zorrro13 (and NightHawkeye), you've been a real help to me and I really appreciate it. I heard back from the sleep clinic but I can't get in to see the doc until 26 June, so I'm on my own till then. Well, not on my own I guess, with the fantastic help I'm getting here. Thanks guys

NightHawkeye · Post by **NightHawkeye** » Fri May 23, 2008 6:02 am

Maddcow wrote:The most noticeable difference last night was that it was a lot harder to keep my mouth closed. I found that my cheeks would suddenly fill with air occasionally and I'd end up having to swallow it because I'd taped my mouth closed. However, at around 5am this morning I removed the damp tape and started mouth-leaking (you can see it on the leak chart!).

That could also be related to the EPR, Gary. I noticed the cheek-puffing thing myself when I was using BiPAP a while back. I don't experience it with CPAP or APAP though, even though I do occasionally mouth-leak from time to time. I agree with Zorro13 that you should crank the EPR down to the least amount you're comfortable with. From a therapy perspective, OFF might be even better, if that's not uncomfortable for you and you can get to sleep with it that way.

Maddcow wrote:I'll have to see how I go with increasing the pressure......up to 16 or 17 is getting pretty darn high so I might see how I do without EPR.

Just don't make the changes so radical that you can't sleep. You seem to be able to sleep the way things are now, so slow changes are OK.

Bill

Maddcow · Post by **Maddcow** » Fri May 23, 2008 7:56 pm

Well, something may be starting to work. Check out below....

Sure, I had some bad leaks a few times but the incidence of events is certainly lower.

zorrro13 · Post by **zorrro13** » Fri May 23, 2008 8:29 pm

Great news Gary

your previous graph shows this
AI: 6.3
HI: 15.8
AHI: 22.1

your current graph

AI 2.4
HI 9.9
AHI 12.3

You have reduced you overall AHI by nearly 50%
but the big one is AI which is down nearly by two thirds

Just fine tuning now and making sure no mouth leaks. A different mask might help such as the Activa, built like a tank.

Man you can sleep! I can only get in 6.5 hours max

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CPAPopedia Keywords Contained In This Post (Click For Definition): activa, news, AHI

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CPAPopedia Keywords Contained In This Post (Click For Definition): activa, news, AHI

Maddcow · Post by **Maddcow** » Fri May 23, 2008 10:38 pm

zorrro13 wrote:Man you can sleep! I can only get in 6.5 hours max

That's only because I've been so bloody exhausted from sleep debt!!! Ha ha! I used to average around 6-7 hours. Also, Saturday is our sleep-in day.....our 11yr old daughter was taught this from a very young age

EDIT: It was good to get the AI down but I'd really like to reduce the HI too.....that's the one factor that seems to be the hardest to reduce. I'm going to try 14cm tonight (no EPR again). I also went and bought some gaffa tape today to really make sure I get that mouth shut up tight......but I don't think I'll need to shave around my mouth area from now on!

Maddcow · Post by **Maddcow** » Wed May 28, 2008 12:09 am

Well, I got rid of the Swift II and am trialling a Quattro and Activa. My first night with the Quattro was absolutely terrible......every time I moved, it leaked. I finally managed to get some decent sleep after pulling the straps so tight I woke up with a really bad neck and some killer lines on my face.

BUT, the loan Activa arrived yesterday and I was blown away by this last night! No matter how or which way I moved, that sucker (literally) stuck to my face like glue. I could even significantly loosen the straps so that there was hardly any tension at all in my head and neck!

Zorrro13, I have to say that I'm pretty sure the Activa is going to be the mask for me. Thanks heaps for that advice! I really wasn't too keen on the much bigger interface (compared to the Swift II) but results are results. I also quite like the detachable elbow joint at the front....that makes it a lot easier to go to the loo in the middle of the night!

zorrro13 · Post by **zorrro13** » Wed May 28, 2008 12:23 am

Activa defies mask logic and seems the looser the better. I'm buying a second one next week as mine is 18mths old and seals great but wont last forever

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